<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Gsname')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-gsname" readonly data-rule="required" class="form-control" name="row[gsname]" type="text" value="{$customer.gsname}">
        </div>
    </div>


    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Kpssyf')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-kpssyf" data-rule="" class="form-control datetimepicker" data-date-format="YYYY-MM" data-use-current="true" name="row[kpssyf]" style="font-size: 20px;" type="text" value="{:date('Y-m')}">

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Gthmz')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-gthmz" data-rule="required" class="form-control" name="row[gthmz]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Kpje')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-kpje" data-rule="required" class="form-control" name="row[kpje]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Yqsqfwf')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-yqsqfwf" data-rule="required" class="form-control" name="row[yqsqfwf]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Yqsqsj')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-yqsqsj" data-rule="required" class="form-control" name="row[yqsqsj]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Zhsl')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-zhsl" class="form-control" name="row[zhsl]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sskh')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sskh" data-rule="required" class="form-control" name="row[sskh]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-remark"  class="form-control" name="row[remark]" type="text" value="">
        </div>
    </div>

    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
